Knowledge, Attitudes and Practices on Vector-Borne Diseases in Switzerland – 2025
Supplement
Lilian Goepp, Nina Huber, Arlette Szelecsenyi, Julien Riou
2025-09-04
analysis_date = "2025-09-03"
load(paste0("savepoints/savepoint_",analysis_date,"/brs_3.Rdata"))
source("R/setup.R")
knitr::opts_chunk$set(echo = FALSE)
set_gtsummary_theme(list(
"tbl_summary-fn:percent_fun" = function(x) style_percent(x, digits = 1)
))1 Sociodemography and exposure
1.1 Sociodemography
| Characteristic | N = 9911 |
|---|---|
| What sex were you assigned at birth? | |
| Female | 557 (56.2%) |
| Male | 434 (43.8%) |
| Intersex | 0 (0%) |
| Which of the following labels best describes your social and felt gender? | |
| Female | 550 (56.1%) |
| Male | 427 (43.5%) |
| Other | 4 (0.41%) |
| (Missing) | 10 |
| What is your highest completed education? | |
| None | 1 (0.11%) |
| Incomplete compulsory schooling | 1 (0.11%) |
| Compulsory schooling | 22 (2.32%) |
| One-year transitional program | 4 (0.42%) |
| General education school | 16 (1.69%) |
| Apprenticeship/vocational school | 182 (19.2%) |
| Gymnasial maturity | 52 (5.49%) |
| Professional maturity | 18 (1.90%) |
| Federal diploma exam | 101 (10.7%) |
| Higher vocational school | 114 (12.0%) |
| Bachelor degree | 138 (14.6%) |
| Master degree | 215 (22.7%) |
| Doctorate/habilitation | 84 (8.86%) |
| (Missing) | 43 |
| Since when have you been living in Switzerland? | |
| Since birth | 740 (74.9%) |
| Born in Switzerland but also lived abroad | 60 (6.07%) |
| Born abroad | 188 (19.0%) |
| (Missing) | 3 |
| What is your marital status? | |
| Married, living with spouse | 529 (55.5%) |
| Married, permanently separated | 10 (1.05%) |
| Registered partnership, living together | 3 (0.31%) |
| Registered partnership, separated | 1 (0.10%) |
| Single, stable partnership | 150 (15.7%) |
| Single, living alone | 126 (13.2%) |
| Divorced | 96 (10.1%) |
| Widowed | 38 (3.99%) |
| (Missing) | 38 |
| Occupation according to CH-ISCO 2019 | |
| Administrative support staff | 186 (31.7%) |
| Directors, senior executives and managers | 3 (0.51%) |
| Intellectual and scientific professions | 59 (10.1%) |
| Intermediate occupations | 230 (39.2%) |
| Personal services staff, shopkeepers and sales assistants | 108 (18.4%) |
| (Missing) | 405 |
| 1 n (%) | |
1.2 Exposures from inclusion questionnaire
Almost all participants (98.2%) reported having received vaccines at some point, and most indicated full mobility, with 87.1% having no problems walking and fewer than 4% reporting moderate to severe difficulties. A large majority (99.8%) had traveled abroad for more than two days, with Europe being the most frequently visited continent (94%), followed by North America (60.4%), Asia (54.1%), and Africa (46.5%). When asked about future pandemic preparedness, respondents highlighted the importance of combating misinformation (69.7%) and maintaining public awareness (68.2%) and government commitment (55.8%). Other challenges mentioned included strengthening pathogen surveillance (35.4%) and addressing regulatory barriers in vaccine production (28.6%), while climate change mitigation (18.2%) and ventilation improvements (12.8%) were less commonly emphasized.
| Characteristic | N = 9911 |
|---|---|
| Have you ever received any vaccines? | |
| Yes | 960 (98.2%) |
| No | 18 (1.84%) |
| (Missing) | 13 |
| Please select what best describes your mobility today | |
| I have no problems walking around | 844 (87.1%) |
| I have slight problems walking around | 89 (9.18%) |
| I have moderate problems walking around | 28 (2.89%) |
| I have severe problems walking around | 8 (0.83%) |
| I am unable to walk around | 0 (0%) |
| (Missing) | 22 |
| Have you ever stayed abroad for more than two days? | |
| Yes | 955 (99.8%) |
| No | 2 (0.21%) |
| (Missing) | 34 |
| On which continent? | |
| Europe | 932 (94.0%) |
| North America | 599 (60.4%) |
| Central America | 184 (18.6%) |
| South America | 243 (24.5%) |
| Africa | 461 (46.5%) |
| Asia | 536 (54.1%) |
| Oceania | 215 (21.7%) |
| (Missing) | 0 |
| Thinking about the next pandemic, what do you see as the main challenges for preparedness? | |
| Maintaining public awareness of a possible pandemic | 676 (68.2%) |
| Maintaining government commitment to pandemic preparedness | 553 (55.8%) |
| Mitigating the effects of climate change | 180 (18.2%) |
| Regulatory barriers to scaling up vaccine production in low- and middle-income countries | 283 (28.6%) |
| Strengthening surveillance to identify potential pandemic pathogens | 351 (35.4%) |
| Combating misinformation about pandemic threats | 691 (69.7%) |
| Installing adequate ventilation in workplaces and homes | 127 (12.8%) |
| (Missing) | 0 |
| 1 n (%) | |
The EQ VAS records the patient’s self-rated health on a vertical visual analogue scale where the endpoints are labelled ‘The best health you can imagine’ and ‘The worst health you can imagine’. The VAS can be used as a quantitative measure of health outcome that reflects the patient’s own judgement. We observe an average of 83 (SD 12.8), consistent with a representative survey in French-speaking Switzerland reporting a mean EQ-VAS of 81.7 (SD 15.5) (Perneger, Combescure, and Courvoisier 2010).
1.3 Municipality of residence
For each municipality in the canton of Bern, we mapped the number of survey respondents. The map illustrates the geographic distribution of the surveyed population, with a markedly higher concentration of respondents in the city of Bern than in the rest of the canton.
2 General knowledge
2.1 Baseline control variables
| Introductory text | N = 9911 |
|---|---|
| Please read the following text carefully before answering the questions: A vector is an organism that can transmit a pathogen (virus, bacterium, or parasite), primarily by feeding on an infected host (human or animal), and then transmitting it to other hosts. Tick-borne encephalitis is a disease transmitted by tick bites. Would you classify it as a vector-borne disease? | |
| Yes | 753 (78.4%) |
| No | 106 (11.0%) |
| I don't know | 102 (10.6%) |
| (Missing) | 30 |
| 1 n (%) | |
| Question | N = 9911 |
|---|---|
| Have you heard of the following diseases? | |
| West Nile fever | 290 (29.3%) |
| Dengue | 876 (88.4%) |
| Zika | 616 (62.2%) |
| Chikungunya | 195 (19.7%) |
| Lyme disease | 751 (75.8%) |
| Influenza | 929 (93.7%) |
| Measles | 945 (95.4%) |
| None of these | 2 (0.20%) |
| (Missing) | 0 |
| Have you heard of the following organisms? | |
| Ticks | 951 (96.0%) |
| Mosquitoes | 949 (95.8%) |
| Wasps | 920 (92.8%) |
| Bed bugs | 911 (91.9%) |
| None of these | 1 (0.10%) |
| (Missing) | 0 |
| 1 n (%) | |
A majority of participants answered consistently when linking vectors to disease transmission, but a minority displayed contradictions. About 6% denied ticks or mosquitoes as transmitters while simultaneously identifying them as responsible for disease transmission. In total, 10.7% of respondents contradicted themselves in at least one case. This suggests that while knowledge was generally coherent, a small but notable share of respondents held conflicting beliefs or had difficulties applying knowledge consistently.
| Question | N = 9911 |
|---|---|
| Denied tick as transmitter and identified ticks as transmiting a disease | |
| Consistent | 902 (94.1%) |
| Contradiction | 57 (5.94%) |
| (Missing) | 32 |
| Denied mosquitoes transmitter and identified mosquitoes as transmiting a disease | |
| Consistent | 896 (94.0%) |
| Contradiction | 57 (5.98%) |
| (Missing) | 38 |
| Any of the two contradiction | |
| Consistent | 850 (89.3%) |
| Contradiction | 102 (10.7%) |
| (Missing) | 39 |
| 1 n (%) | |
2.1.1 Filtering
To ensure data quality and consistency, we used Supplementary table 3 and Supplementary table 5 to exclude respondents who either lacked a basic understanding of vector-borne disease diseases or provided logically inconsistent answers throughout the questionnaire. This process ensures that responses reflect a reliable snapshot of participants’ knowledge and that the respondents don’t adapt their answers during the completion of the questionnaire. In total, 282 individuals were excluded based on these criteria, leaving a final sample of 709 participants for analyzing the results of the knowledge follow-up questions.
2.2 Item-level accuracy
| Test item | N = 7091 |
|---|---|
| Question : Which of these diseases do you think are vector-borne diseases? | |
| (Missing) | 0 |
| West Nile correctly classified as VBD | |
| Incorrect | 421 (59.4%) |
| Correct | 288 (40.6%) |
| Dengue correctly classified as VBD | |
| Incorrect | 98 (13.8%) |
| Correct | 611 (86.2%) |
| Zika correctly classified as VBD | |
| Incorrect | 222 (31.3%) |
| Correct | 487 (68.7%) |
| Chikungunya correctly classified as VBD | |
| Incorrect | 480 (67.7%) |
| Correct | 229 (32.3%) |
| Lyme correctly classified as VBD | |
| Incorrect | 121 (17.1%) |
| Correct | 588 (82.9%) |
| Influenza correctly classified as not a VBD | |
| Incorrect | 142 (20.0%) |
| Correct | 567 (80.0%) |
| Measles correctly classified as not a VBD | |
| Incorrect | 123 (17.3%) |
| Correct | 586 (82.7%) |
| 1 n (%) | |
| Test item | N = 7091 |
|---|---|
| Question : Which of these organisms transmit diseases to humans? | |
| (Missing) | 0 |
| Ticks correctly identified as transmitting disease | |
| Incorrect | 0 (0%) |
| Correct | 709 (100.0%) |
| Mosquitoes correctly identified as transmitting disease | |
| Incorrect | 9 (1.27%) |
| Correct | 700 (98.7%) |
| Wasps correctly identified as not transmitting disease | |
| Incorrect | 46 (6.49%) |
| Correct | 663 (93.5%) |
| Bed bugs identified as not transmitting disease | |
| Incorrect | 163 (23.0%) |
| Correct | 546 (77.0%) |
| 1 n (%) | |
| Test item | N = 7091 |
|---|---|
| Question : Match each disease on the left with its vector on the right (one per row). E.g. ’tick-borne encephalitis’ -> ’ticks’. | |
| TBE correctly matched to ticks | |
| Incorrect | 3 (0.42%) |
| Correct | 704 (99.6%) |
| West Nile correctly matched to mosquitoes | |
| Incorrect | 278 (43.4%) |
| Correct | 363 (56.6%) |
| Dengue correctly matched to mosquitoes | |
| Incorrect | 77 (11.1%) |
| Correct | 616 (88.9%) |
| Zika correctly matched to mosquitoes | |
| Incorrect | 184 (27.7%) |
| Correct | 480 (72.3%) |
| Chikungunya correctly matched to mosquitoes | |
| Incorrect | 361 (58.2%) |
| Correct | 259 (41.8%) |
| Lyme correctly matched to ticks | |
| Incorrect | 87 (12.4%) |
| Correct | 613 (87.6%) |
| Influenza correctly matched to none | |
| Incorrect | 42 (6.62%) |
| Correct | 592 (93.4%) |
| Measles correctly matched to none | |
| Incorrect | 48 (7.61%) |
| Correct | 583 (92.4%) |
| 1 n (%) | |
2.3 Overall knowledge score
We hereby display a more detailed visualization of the repartition of the overall knowledge score by highlighting the relative contribution of knowledge test items (recognizing organisms as vectors, recognizing diseases as VBDs, matching diseases with their corresponding vector) or associated vectors (Wasp/bed bugs distractors, Ticks, Mosquitoes). The ability to identify vector-borne diseases and knowledge about mosquitoes and mosquito-borne diseases appear as important drivers of the overall knowledge score.
3 Individual exposure : open-ended answers
Most respondents reported vaccination against tick-borne encephalitis (FSME/TBE) as their main preventive measure, often mentioning it explicitly for themselves or their children. A smaller number referred to protecting pets (e.g., with tick collars or treatments) as an indirect preventive strategy. Few participants mentioned other measures such as avoiding tall grass or forests, wearing protective clothing or hats, using repellents (sprays, oils, patches), or employing unconventional approaches such as vinegar, vitamin B, or ceramic bracelets. Overall, vaccination was by far the most commonly cited individual preventive action, with other measures appearing rarely and in isolated cases.
Respondents described a wide range of individual strategies to prevent mosquito bites. Common measures included the use of repellents such as insect sprays, mosquito-repellent candles, incense sticks, essential oils (e.g., lavender, clove, oregano), and specialized diffusers or bracelets. Several participants reported installing or using physical barriers such as mosquito nets, insect screens, or curtains, and others emphasized behavioral measures, including keeping lights off in the evening, ventilating rooms during the day, and avoiding open windows at night. Some mentioned directly eliminating mosquitoes indoors through catching, swatting, or using electric devices. Additional approaches included reducing breeding sites by covering or regularly changing standing water, maintaining bat-friendly gardens, or applying larvicides. A few respondents also referred to vaccination or the use of vitamin supplements as protective measures.